title: Long-term Doppler hemodynamics and effective orifice areas of Edwards SAPIEN and medtronic CoreValve prostheses after TAVI.
abstract: BACKGROUND
  Although initial hemodynamics of percutaneously implanted aortic bioprostheses compare favorably to surgically implanted valves, the durability of the flow characteristics remains unknown. As biological prostheses are at potential risk for early degeneration, the aim of our study was to compare Doppler hemodynamics and effective orifice area (EOA) directly after and at least 1 year after valve implantation.
  
  
  METHODS
  In this monocentric, prospective study, we determined peak velocity, peak and mean systolic gradients, and EOA by echocardiography in 75 patients (Edwards SAPIEN, n = 20; CoreValve, n = 55) 1 week (median 7 ± 25 days) and 1 year (median 378 ± 157 days, maximum 1034 days) after transcatheter aortic valve implantation (TAVI).
  
  
  RESULTS
  After 12 months, Doppler performance of the aortic valve prostheses remained unchanged. The peak instantaneous velocity was 1.9 ± 0.4 m/s directly after TAVI versus 1.8 ± 0.5 m/s (P = ns) at follow-up, with a mean gradient of 8.5 ± 3.7 mmHg and 8.1 ± 4.2 (P = ns), respectively. Interestingly, the degree of mitral regurgitation (MR) decreased significantly (P = 0.007) over time, and the severity of aortic regurgitation (AR) remained unchanged during follow-up (P = ns).
  
  
  CONCLUSIONS
  For at least 1 year after TAVI, the excellent Doppler hemodynamics and EOA are preserved in transcatheter aortic valve prostheses, and the severity of MR decreased significantly. In addition, we found no evidence of early valve deterioration or progression of AR.
authors.affiliation: Department of Cardiology and Angiology, Campus Charité Mitte, Charité - University Medicine Berlin, Berlin, Germany; Department of Internal Medicine, Bundeswehrkrankenhaus, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Spethmann
authors.forename: Henryk
authors.initials: H
authors.lastname: Dreger
authors.forename: Gerd
authors.initials: G
authors.lastname: Baldenhofer
authors.forename: Eyleen
authors.initials: E
authors.lastname: Pflug
authors.forename: Wasiem
authors.initials: W
authors.lastname: Sanad
authors.forename: Verena
authors.initials: V
authors.lastname: Stangl
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Herko
authors.initials: H
authors.lastname: Grubitzsch
authors.forename: Michael
authors.initials: M
authors.lastname: Sander
authors.forename: Karl
authors.initials: K
authors.lastname: Stangl
authors.forename: Michael
authors.initials: M
authors.lastname: Laule
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods*; D015331:Cohort Studies; D016001:Confidence Intervals; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Doppler echocardiography; aortic stenosis; prosthetic valves